800-637-5088
Jim Lyons Insurance Agency
800-637-5088
ExchangeGuard® Essential - International Insurance for J1 Exchange Visitors and F1 Students
Please use this high level information as a guide only and do not make any decisions solely based on this information. If you have any concerns, doubts or questions, please refer to the individual policy details for complete information, as it is not possible to accurately represent all the details in concise information such as follows, or call us for further details. If there is any discrepancy between this information and the actual policy details, the policy details will override.
All the amounts are in U.S. dollars.
Vision (eyeglasses, etc.) is not covered in any of the plans.
General
Medical - Outpatient
至最高保额
美国紧急护理/无需预约门诊：自付额免除，$15共付额；$0自付额除外。共同保险仍适用。
美国境外：无共付额。
至最高保额
美国境内：如果因疾病去急诊但未住院，另付$250共付额。
至最高保额 , 每次提供60天处方药。
至最高保额
至最高保额
至最高保额
主刀医生费用的20%，不包括旁站医生。
至最高保额
至最高保额
Medical - Inpatient
至最高保额, 包括护理服务的标准双人病房。
至最高保额
至最高保额
至最高保额
主刀医生费用的20%，不包括旁站医生。
至最高保额
至最高保额
Medical - Other Treatment And Services
90 天
标准基础医院病床和/或标准轮椅租赁不超过购买价格
包括：休闲
如果因承保的疾病/受伤住院，至最高保额。
仅限前26周妊娠并发症。
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-
-
物理治疗和按摩脊柱治疗护理: 最多$500。
United Healthcare PPO
Network of physicians, hospitals, urgent cares, labs and other healthcare providers.
No network for pharmacies, dentists, ambulance.
12个月等待期后, 每个保单期$500。
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-
-
-
包括
Dental
Travel
$10,000
每件 $50, 最多 $1,000
$50,000
$100,000, 最多15 天
$1,000,000
至最高保额
$5,000
$100,000
Life
18岁以下: $5,000, 18-64 岁: $25,000; 每个家庭或团体最多$250,000。
18岁以下: $10,000, 18-64 岁: $50,000; 每个家庭或团体最多$250,000。
Other
每位家长最多可免费带一个10岁以下儿童, 最多可免费带两个儿童。
附带: 常居国美国：每3个月15天。常居国非美国：每3个月30天。
$100 每天
-
每天 $250 , 最多5 天
$25,000
仅 $50,000 符合要求医疗费用
承保您本国境外的旅行
Plan Features
保险生效前, 全额退款。
保险生效后, 只要无任何理赔记录可按比例退款并减去$25取消费。
最少5天最多4年
$0
旅行延误超过12个小时并意外过夜停留 - $100/天, 最多2天。
紧急眼科检查 - 每次事故共付额$50，最高$150（保险自付额免除）。
病房探视: $1,500
宠物送返: $1,000
危机响应: $10,000
护照或旅行签证丢失或被盗: $100
电子邮件
邮政
快递
可选
$0 0-64
$100 0-64
$250 0-64
$500 0-64
每次事故
$100,000 0-64
$250,000 0-64
$500,000 0-64
WorldTrips
Lloyd's
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- For medical benefits, to policy maximum, refer to the Usual, Reasonable and Customary Charges. Deductible and coinsurance apply, unless otherwise noted.
- Whenever there is a difference in benefits levels within PPO network and outside PPO network, the benefits shown above are applicable when availing treatment within PPO network.
- Coverages shown are per person unless noted otherwise.
- The dash (-) in the fields above means Not Applicable (N/A).